祛痒化湿方熏洗坐浴联合常规肛周封闭治疗肛周湿疹瘙痒(脾虚湿热型)的效果及对血清IFN-γ、TNF-α、IL-18水平的影响  

Efficacy of Fumigation and Sitz Bath with Quyang Huashi Formula Combined with Conventional Perianal Closure in the Treatment of Perianal Eczema Pruritus(Spleen Deficiency and Dampness-heat Type)and Its Influence on Serum IFN-γ,TNF-αand IL-18 Levels

作　　者：杨苏琴[1] 吴云翔[1] YANG Suqin;WU Yunxiang(The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China;不详)

机构地区：[1]江西中医药大学附属医院,江西南昌330006

出　　处：《中国医学创新》2023年第12期90-94,共5页Medical Innovation of China

摘　　要：目的:探究祛痒化湿方熏洗坐浴联合常规肛周封闭对脾虚湿热型肛周湿疹瘙痒患者炎症因子及临床疗效的影响。方法:选取2020年1月-2022年6月于江西中医药大学附属医院就诊的脾虚湿热型肛周湿疹瘙痒患者84例,采用随机信封法分为研究组(n=42)和对照组(n=42)。对照组采用常规肛周封闭进行治疗,研究组在对照组的基础上联合祛痒化湿方熏洗坐浴进行治疗。两组患者均进行治疗2周。比较两组治疗前及治疗2周后中医症候积分、临床症状评分(湿疹形态、湿疹面积、肛门瘙痒、肛周渗液)、炎症因子[γ干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白介素-18(IL-18)]、免疫因子[免疫球蛋白E(IgE)、Treg细胞比率、Th17细胞比率、嗜酸性粒细胞(EOS)]水平,并记录两组患者治疗期间不良反应发生情况。结果:治疗2周后,两组患者中医症候各项积分、临床症状评分、TNF-α、IL-18、IgE、Th17细胞比率、EOS水平均低于治疗前,且研究组均低于对照组(P<0.05);治疗2周后,两组患者IFN-γ、Treg细胞比率水平均高于治疗前,且研究组均高于对照组(P<0.05)。治疗期间,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:祛痒化湿方熏洗坐浴联合常规肛周封闭可有效改善脾虚湿热型肛周湿疹瘙痒患者临床症状,降低机体炎症反应,改善患者免疫功能,具有较好的安全性。Objective:To explore the influence of fumigation and sitz bath with Quyang Huashi Formula combined with conventional perianal closure on inflammatory factors and clinical efficacy in patients with spleen deficiency and dampness-heat type of perianal eczema pruritus.Method:A total of 84 patients with perianal eczema pruritus of spleen deficiency and dampness-heat type who were treated in the Affiliated Hospital of Jiangxi University of Chinese Medicine from January 2020 to June 2022 were selected,they were divided into study group(n=42)and control group(n=42)by the random envelope method.The control group was treated with conventional perianal closure,while the study group was combined with fumigation and sitz bath with Quyang Huashi Formula on the basis of the control group.Patients in both groups were treated for 2 weeks.The TCM syndromes scores,clinical symptoms scores(eczema morphology,eczema area,anal pruritus,perianal exudate),inflammatory factors[interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-18(IL-18)],immune factors[immunoglobulin E(IgE),Treg cell ratio,Th17 cell ratio,eosinophil(EOS)]before treatment and after 2 weeks of treatment were compared between the two groups,and the occurrence of adverse reactions during treatment were recorded in the two groups.Result:After 2 weeks of treatment,the scores of various TCM syndromes,scores of clinical symptoms,levels of TNF-α,IL-18 and IgE,Th17 cell ratio and EOS level in the two groups were lower than those before treatment,those in study group were lower than those in control group(P<0.05).The IFN-γlevel and Treg cell ratio in both groups after 2 weeks of treatment were higher than those before treatment,those in study group were higher than those in control group(P<0.05).During treatment,there was no significant difference in the total incidence rate of adverse reactions between the two groups(P>0.05).Conclusion:Fumigation and sitz bath with Quyang Huashi Formula combined with conventional perianal closure can effectively improve the clini

关 键 词：肛周湿疹 瘙痒 脾虚湿热 祛痒化湿方 肛周封闭 

分 类 号：R758.23[医药卫生—皮肤病学与性病学]